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All Journal Journal of Biomedicine and Translational Research Indonesian Journal of Tropical and Infectious Disease Universa Medicina Healthy Tadulako Journal (Jurnal Kesehatan Tadulako)
Putri, Vidola Yasena
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Biochemistry, Genetics & Molecular Biology Dentistry Earth & Planetary Sciences Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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In-hospital mortality and its determinant factors among patients with sepsis Fadrian, Fadrian; Decroli, Eva; Ahmad, Armen; Kam, Alexander; Muharramah, Disa Hijratul; Pradana, Genta; Putri, Vidola Yasena
Universa Medicina Vol. 44 No. 1 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.3-15

Abstract

BACKGROUNDSepsis is a heterogeneous syndrome characterized by a variety of clinical features. Multiple studies have identified sepsis as the leading cause of death in hospitalized patients. A comprehensive report on the incidence, clinical characteristics, and predictors of sepsis is important. This study aimed to determine the relative importance of predictors of in-hospital mortality in sepsis. METHODSA retrospective cohort study at Dr. M. Djamil Central General Hospital focused on sepsis patients. A total of 200 participants, aged 18 and older, were included based on specific criteria and recruited through consecutive sampling. Data was gathered from medical records and laboratory results to identify factors influencing mortality in sepsis patients. These factors were classified into sociodemographic, intrinsic, and extrinsic categories. Statistical analysis utilized simple and multiple logistic regression. A p-value of less than 0.05 indicated statistical significance for predicting in-hospital mortality in sepsis. RESULTSThe sepsis patient mortality rate was 69.50%. Hospital-acquired pneumonia (HAP) emerged as the most common infectious diagnosis, impacting 47.50% of the patients. Type 2 diabetes mellitus (Type 2 DM) was identified as the most frequent comorbidity, present in 36.50% of cases. Multivariate analysis indicated that HAP (adjusted odds ratio [aOR] 2.32; 95% confidence interval [CI] 1.19–4.49; p=0.013) and hyperlactatemia (aOR 2.11; 95% CI 1.06–4.18; p=0.032) significantly increased the risk of mortality in sepsis patients. CONCLUSIONHospital-acquired pneumonia was the primary predictor of mortality in sepsis patients. Timely prediction and evaluation of sepsis outcomes are essential for developing strategies to reduce mortality rates.
Different Sepsis Patient Outcomes Due to Multidrug-Resistant Organisms (MDRO): A Study of Empirical Antibiotic Sensitivity Test Results Fadrian, Fadrian; Ahmad, Armen; Harvindra, Astrid; Putri, Vidola Yasena
Healthy Tadulako Journal (Jurnal Kesehatan Tadulako) Vol. 11 No. 3 (2025)
Publisher : Faculty of Medicine, Universitas Tadulako

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22487/htj.v11i3.1740

Abstract

Background: Sepsis, a severe immune response to infection, has a concerning global mortality rate of 85%, predominantly due to Gram-negative bacteria. The rise of antibiotic resistance in these organisms complicates treatment, leading to higher mortality and prolonged hospital stays. Effective empirical antibiotics can mitigate these outcomes. Objective: This study compares outcomes of sepsis patients infected with multidrug-resistant organisms (MDRO) based on empirical antibiotic sensitivity testing, focusing on mortality and length of stay (LOS) within 14 days of sepsis onset. Methods: A prospective cohort observational study at Dr. M. Djamil General Hospital included 94 participants. Patients who died within 14 days were excluded from the LOS analysis to prevent bias. Initial assessments included culture sampling and organ dysfunction. Results: The study revealed no significant difference in mortality based on antibiotic sensitivity (p=0.283), but the LOS was significantly shorter in those treated with sensitive antibiotics (p<0.016). Conclusion: LOS was significantly affected by antibiotic sensitivity, with patients receiving effective antibiotics experiencing shorter stays, though mortality differences were not statistically significant in the 14-day window
Comparison of the Diagnostic Value of Presepsin and Procalcitonin as Markers of Bacterial Sepsis Fadrian, Fadrian; Ahmad, Armen; Sadeli, Rezki Pratama; Putri, Vidola Yasena; Agustian, Dede Rahman
Indonesian Journal of Tropical and Infectious Disease Vol. 14 No. 1 (2026): January - April Edition
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v14i1.69526

Abstract

Sepsis is a severe condition caused by an improper immune response during infections. Early diagnosis is challenging due to the low specificity and effectiveness of current diagnostic tools. Procalcitonin is a biomarker with both advantages and limitations. Presepsin has emerged as a potential alternative, offering cost-effectiveness, fewer confounding factors, and a quicker response. This study evaluates the diagnostic capabilities of presepsin and procalcitonin in bacterial sepsis. The study involved patients with sepsis who were treated in the Internal Medicine Department at M. Djamil Hospital, Padang, Indonesia. All participants were adults over 18, excluding those with conditions that could affect the biomarkers. A total of 63 patients were assessed. The mean presepsin level in bacterial sepsis was 205.91 pg/mL (±162.65 SD), while procalcitonin averaged 62.83 ng/mL (±80.48 SD). Blood cultures revealed bacterial infections in 18 patients (28.60%). Among them, eight had Gram-positive (44.40%) and ten had Gram-negative bacteria (55.60%). Presepsin demonstrated variable accuracy in identifying bacterial sepsis and bacteremia. The Area Under the Curve (AUC) for bacterial sepsis was 0.60 (95% CI 0.44-0.75), for Gram-positive bacteremia it was 0.63 (95% CI 0.35-0.90), and for Gram-negative bacteremia it was 0.37 (95% CI 0.10-0.65). In contrast, procalcitonin showed an AUC of 0.51 (95% CI 0.35-0.67) for bacterial sepsis, 0.22 (95% CI 0.01-0.46) for Gram-positive bacteremia, and 0.78 (95% CI 0.54-1.00) for Gram-negative bacteremia. Presepsin has a higher diagnostic value than procalcitonin in detecting bacterial sepsis. Procalcitonin has the highest AUC value in all categories for detecting Gram-negative bacteremia.
Comparison Clinical Outcomes of Sepsis Caused by Multidrug-Resistant (MDR) and Non-MDR Klebsiella pneumoniae Fadrian, Fadrian; Ahmad, Armen; Linosefa, Linosefa; Simanjuntak, Rohayat Bilmahdi; Putri, Vidola Yasena
Journal of Biomedicine and Translational Research Vol 12, No 1 (2026): April 2026
Publisher : Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jbtr.v12i1.29019

Abstract

Background: Klebsiella pneumoniae is a common pathogen causing sepsis and is associated with high morbidity and mortality. The emergence of multidrug-resistant organisms (MDROs), particularly extended-spectrum β-lactamase-producing K. pneumoniae (ESBL-KP) and carbapenem-resistant K. pneumoniae (CRKP), has limited antimicrobial therapy options and may worsen clinical outcomes such as mortality and length of hospital stay (LOS). Objective: This study aims to compare the clinical characteristics and outcomes of sepsis caused by multidrug-resistant K. pneumoniae and non-resistant strains, focusing on mortality and LOS.Methods: An observational analytical study with a cohort design was conducted at Dr. M. Djamil General Hospital in Padang from October 2024 to January 2025. Subjects diagnosed with sepsis due to pneumonia and confirmed positive for K. pneumoniae through blood or respiratory cultures were included using consecutive sampling. Isolates were categorized into MDR (ESBL-KP and CRKP) and non-MDR. Clinical data were analyzed descriptively to described subject characteristics, while bivariate analysis (chi-square and independent t-test) evaluated associations between resistance profiles and outcomes, focusing on mortality and LOS (p < 0.05). Results: Of the 70 subjects, 39 (55.7%) had confirmed infection with MDR strains and 31 (44.3%) with non-MDR.Mortality was highest in the CRKP (56.5%), followed by non-MDR (38.7%) and ESBL-KP (25.0%). Statistical analysis revealed a notable association between the resistance profiles of K. pneumoniae and mortality (p < 0.001 for both CRKP and ESBL-KP vs non-MDR). However, there were no statistically significant differences in mean hospital LOS across the groups (CRKP: 16.30 ± 9.81 days; ESBL-KP: 13.63 ± 9.77 days; non-MDR: 16.06 ± 9.49 days; all p > 0.05). Conclusion: Sepsis caused by multidrug-resistant K. pneumoniae, including both ESBL and CRKP, is significantly associated with increased mortality. Early identification and appropriate antimicrobial management are essential to improve subject outcomes. 
Co-Authors Agustian, Dede Rahman Ahmad, Armen Eva Decroli Fadrian, Fadrian Genta Pradana, Genta Harvindra, Astrid Kam, Alexander Linosefa Linosefa Muharramah, Disa Hijratul Sadeli, Rezki Pratama Simanjuntak, Rohayat Bilmahdi